Maddy now calls some of those women — women who used heroin during their pregnancies — her superheroes.
While seated in the chair in which she counsels them, she began to explain why.
“There’s a more of a stigma or shame attached to women who are addicts in general,” Maddy said, a stigma that goes viral when pregnancy is involved.
It’s a stigma she says exists among the women themselves.
Of all the pregnant women she has worked with, “not one of them ever said, ‘I’m going to get pregnant and I’m going to shoot dope,’” Maddy said. “That wasn’t part of the plan.”
The unplanned pregnancies instead emerged in the flow of the desperate, everyday life of an addict.
“A lot of people don’t know they’re pregnant until they’re well into their pregnancy,” Maddy said.
One reason is that the morning sickness that often signals pregnancy is much like the morning sickness that accompanies opiate withdrawal.
And, as with male addicts who aren’t at risk for pregnancy, the fear of that withdrawal, “overrides everything,” Maddy said.
Even among those women who know early on that they’re pregnant, “there’s such a fear of withdrawing,” she said, that they’re unable to stop using without help.
Many have told her of how many times they went to bed each night determined that the next day would be the day they’d stop using, only to wake up in the morning feeling sick and spending the rest of the day finding a fix.
Maddy said most of the women are “just on a hamster wheel” of use in which one day spins into the next, “and the next thing you know, they’re ready to deliver a baby.”
The fear of withdrawal isn’t the only fear that keeps them on the wheel. Using direct quotes from her clients, Maddy has made a poster that’s on display at McKinley Hall.
“My family doesn’t know about my addiction.”
“I might go to jail.”
“I will lose my baby.”
“I’m so ashamed.”
“People will think I’m a horrible person.”
It’s one reason that “when we get people here” during their pregnancies, “we love on them,” Maddy said.
For those who arrive early in their pregnancies — Maddy said the fourth month is usually when it’s apparent to them — “we detox them and taper them (off the withdrawal drug Subutex), so they can go through their whole pregnancy and deliver a healthy baby.”
Restoring the health of the mother and providing solid prenatal care is crucial for the child’s health, she said, and can be a turning point in the mother’s recovery, especially if someone has used during a previous pregnancy.
“And in this process, after the baby is born, they learn about birth control and pregnancy prevention,” Maddy said, and how to take control of lives that have skittered out of control.
“When they get to deliver that baby and know that they did do this work to help,” Maddy said, it represents an accomplishment, a step toward recovery and “one level of shame that they don’t have to deal with.”
Working through the rest of their shame and taking responsibility for their actions is an important part of recovery, she said.
While they’re doing that, she said therapists try to teach them problem solving skills and techniques that can help them rebuild their lives, sometimes from scratch.
The good news, said Maddy: “If they have those good coping skills and good life skills, then they can do anything.”
“I’ve seen women go on to be phenomenal mothers, just phenomenal mothers, using the experiences they have had and the lessons they’ve learned,” she said.
The path to that is much rockier for women who arrive at treatment late in their pregnancies or at labor and delivery while still using.
Not only are their babies at higher risk for problems, once the babies are born, the fears scrawled on the poster Maddy created are scrawled on the women’s lives.
Children’s Services is summoned and some of the mothers “can’t ever reunify with their kids,” Maddy said. “We try to prepare them for that.”
To rebuild their lives, those women have to figure out a way to live with that while getting clean and, in the long term, staying clean.
Maddy sees the women who have the strength to pull that off as superheroes.
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